NSG 3800 Final Exam V1 | NSG 3800 Nursing Practice – Adult Health II
| Actual Q&A with Rationale (NSG3800 Final Exam) | Galen
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with high levels of Positive End-Expiratory Pressure (PEEP). The nurse should
monitor for which significant complication?
A. Increased cardiac output
B. Metabolic alkalosis
C. Pneumothorax
D. Hypokalemia
Answer: C
Rationale: High PEEP levels can lead to barotrauma as the alveoli are over-distended. This
over-distention can cause a pneumothorax by rupturing the alveolar walls. The nurse must
assess for sudden respiratory distress and decreased breath sounds on the affected side.
2. Which clinical manifestation is a hallmark sign of the ‘cold’ or late stage of septic shock?
A. Tachycardia and flushed skin
B. Increased urinary output
C. Hypotension and cool, clammy skin
D. Bounding peripheral pulses
Answer: C
Rationale: In late-stage septic shock, the body loses its compensatory mechanisms, leading
to a decrease in cardiac output. This results in poor tissue perfusion, manifested by cold,
clammy skin and hypotension. The nurse should recognize this as a critical decline in the
patient’s hemodynamic status.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which laboratory finding should
the nurse expect to see?
A. Serum glucose 150 mg/dL
B. Negative ketones in the urine
C. Arterial pH 7.20
D. Bicarbonate level of 28 mEq/L
Answer: C
,Rationale: DKA is characterized by metabolic acidosis due to the accumulation of ketones.
An arterial pH of 7.20 indicates acidosis, which is consistent with this condition. The nurse
will also typically see high glucose levels and low bicarbonate levels.
4. What is the priority intervention for a patient experiencing Autonomic Dysreflexia?
A. Administering a bolus of IV fluids
B. Placing the patient in a supine position
C. Checking the patient’s bladder for distention
D. Applying heat to the lower extremities
Answer: C
Rationale: Autonomic dysreflexia is a medical emergency often triggered by a full bladder
or impacted bowel. The first nursing action is to elevate the head of the bed to 90 degrees
and then identify and remove the stimulus. Checking the bladder for distention is a critical
step in resolving the underlying cause.
5. In a patient with Acute Kidney Injury (AKI), the nurse notes a potassium level of 6.8 mEq/L.
Which medication should the nurse anticipate administering first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Spironolactone
D. Furosemide
Answer: B
Rationale: Calcium gluconate is administered in severe hyperkalemia to stabilize the
myocardial cell membrane. This helps prevent life-threatening arrhythmias while other
treatments work to lower the potassium level. It does not lower the potassium itself but
provides immediate cardiac protection.
6. A patient with liver cirrhosis and ascites is prescribed Lactulose. What is the primary
purpose of this medication in this patient?
A. To decrease serum ammonia levels
B. To reduce abdominal girth
C. To increase serum albumin
D. To treat underlying hepatitis
Answer: A
Rationale: Lactulose is used to treat hepatic encephalopathy by promoting the excretion of
ammonia through the stool. By acidifying the colon, it converts ammonia into ammonium,
, which is not absorbed into the bloodstream. The nurse monitors the patient’s mental status
and stool frequency to evaluate effectiveness.
7. Which EKG change is most characteristic of Hyperkalemia?
A. ST-segment depression
B. Presence of U waves
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Rationale: Hyperkalemia typically causes tall, peaked T waves on an EKG. As potassium
levels rise further, the PR interval lengthens and the QRS complex widens. Recognizing
these changes is vital for preventing cardiac arrest.
8. A patient is admitted with a diagnosis of pheochromocytoma. Which vital sign should the
nurse monitor most closely?
A. Temperature
B. Oxygen Saturation
C. Respiratory Rate
D. Blood Pressure
Answer: D
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes
catecholamines, leading to severe hypertension. Patients are at high risk for hypertensive
crisis, which can cause stroke or organ damage. The nurse must prioritize monitoring and
managing blood pressure.
9. A nurse is caring for a patient with a chest tube. The nurse notes continuous bubbling in
the water-seal chamber. What does this indicate?
A. Normal function during exhalation
B. The lung has fully re-expanded
C. There is an air leak in the system
D. Suction is set too high
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak between
the patient and the drainage system. Intermittent bubbling is normal if the patient has a
pneumothorax and is coughing or exhaling. The nurse should troubleshoot the system
starting from the insertion site to the drainage unit.
| Actual Q&A with Rationale (NSG3800 Final Exam) | Galen
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with high levels of Positive End-Expiratory Pressure (PEEP). The nurse should
monitor for which significant complication?
A. Increased cardiac output
B. Metabolic alkalosis
C. Pneumothorax
D. Hypokalemia
Answer: C
Rationale: High PEEP levels can lead to barotrauma as the alveoli are over-distended. This
over-distention can cause a pneumothorax by rupturing the alveolar walls. The nurse must
assess for sudden respiratory distress and decreased breath sounds on the affected side.
2. Which clinical manifestation is a hallmark sign of the ‘cold’ or late stage of septic shock?
A. Tachycardia and flushed skin
B. Increased urinary output
C. Hypotension and cool, clammy skin
D. Bounding peripheral pulses
Answer: C
Rationale: In late-stage septic shock, the body loses its compensatory mechanisms, leading
to a decrease in cardiac output. This results in poor tissue perfusion, manifested by cold,
clammy skin and hypotension. The nurse should recognize this as a critical decline in the
patient’s hemodynamic status.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which laboratory finding should
the nurse expect to see?
A. Serum glucose 150 mg/dL
B. Negative ketones in the urine
C. Arterial pH 7.20
D. Bicarbonate level of 28 mEq/L
Answer: C
,Rationale: DKA is characterized by metabolic acidosis due to the accumulation of ketones.
An arterial pH of 7.20 indicates acidosis, which is consistent with this condition. The nurse
will also typically see high glucose levels and low bicarbonate levels.
4. What is the priority intervention for a patient experiencing Autonomic Dysreflexia?
A. Administering a bolus of IV fluids
B. Placing the patient in a supine position
C. Checking the patient’s bladder for distention
D. Applying heat to the lower extremities
Answer: C
Rationale: Autonomic dysreflexia is a medical emergency often triggered by a full bladder
or impacted bowel. The first nursing action is to elevate the head of the bed to 90 degrees
and then identify and remove the stimulus. Checking the bladder for distention is a critical
step in resolving the underlying cause.
5. In a patient with Acute Kidney Injury (AKI), the nurse notes a potassium level of 6.8 mEq/L.
Which medication should the nurse anticipate administering first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Spironolactone
D. Furosemide
Answer: B
Rationale: Calcium gluconate is administered in severe hyperkalemia to stabilize the
myocardial cell membrane. This helps prevent life-threatening arrhythmias while other
treatments work to lower the potassium level. It does not lower the potassium itself but
provides immediate cardiac protection.
6. A patient with liver cirrhosis and ascites is prescribed Lactulose. What is the primary
purpose of this medication in this patient?
A. To decrease serum ammonia levels
B. To reduce abdominal girth
C. To increase serum albumin
D. To treat underlying hepatitis
Answer: A
Rationale: Lactulose is used to treat hepatic encephalopathy by promoting the excretion of
ammonia through the stool. By acidifying the colon, it converts ammonia into ammonium,
, which is not absorbed into the bloodstream. The nurse monitors the patient’s mental status
and stool frequency to evaluate effectiveness.
7. Which EKG change is most characteristic of Hyperkalemia?
A. ST-segment depression
B. Presence of U waves
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Rationale: Hyperkalemia typically causes tall, peaked T waves on an EKG. As potassium
levels rise further, the PR interval lengthens and the QRS complex widens. Recognizing
these changes is vital for preventing cardiac arrest.
8. A patient is admitted with a diagnosis of pheochromocytoma. Which vital sign should the
nurse monitor most closely?
A. Temperature
B. Oxygen Saturation
C. Respiratory Rate
D. Blood Pressure
Answer: D
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes
catecholamines, leading to severe hypertension. Patients are at high risk for hypertensive
crisis, which can cause stroke or organ damage. The nurse must prioritize monitoring and
managing blood pressure.
9. A nurse is caring for a patient with a chest tube. The nurse notes continuous bubbling in
the water-seal chamber. What does this indicate?
A. Normal function during exhalation
B. The lung has fully re-expanded
C. There is an air leak in the system
D. Suction is set too high
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak between
the patient and the drainage system. Intermittent bubbling is normal if the patient has a
pneumothorax and is coughing or exhaling. The nurse should troubleshoot the system
starting from the insertion site to the drainage unit.
